These questions and answers have appeared in Dr. Arthur Epstein’s “Ask the Doctor” column of past NKCF Newsletters. If you have questions, send them to email@example.com
Questions Answered By Dr. Epstein
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Is it common for KC patients to wear different type lenses in each eye?
Most experienced contact lens fitters try to maintain symmetry with similar lenses in both eyes. This usually simplifies lens care and can avoid a few other potential issues. However, keratoconus fitting can be challenging making two different lenses essential to obtain an ideal fit. I wouldn’t worry about having different lenses brands or even types in each eye, but if it concerns you, just ask your contact lens specialist to explain why they chose that approach.
Has there been any research into using the patient's own stem cells to create a new cornea?
As many of you know stem cell research and efforts to develop a replacement cornea have both been ongoing for many years. While progress has been made, we are still a few years away from any practical applications.
Can keratoconus affect a person's balance?
Balance depends upon input from the inner ear and the visual system. That information is processed by the brain to help orient us in space. Anything that disturbs inner ear function or vision can disrupt balance. Likewise, neurological problems can also cause imbalance.
If you are having balance issues caused by your visual system, they may be due to visual or prescription differences between your two eyes that your doctor may be able to easily correct. Sometimes it may be due to a prescription that has changed.
Because balance problems can have other causes – some potentially serious, you should discuss this with your doctor at your next visit or sooner if it worsens
Since I've been wearing the RPG contacts my eyes get very red, I use drops to get rid of the redness but then it comes back. Is this normal?
First, discontinue the drops. Eye drops for redness usually contain vasoconstrictors (medicine that makes the blood vessels smaller). Over time, the vasoconstrictors become irritating which causes more redness. This sets up a vicious cycle causing some patients to become virtually addicted to these drops. Using preservative free artificial tears can help make the eyes feel more comfortable and do not contain these vasoconstrictor medicines.
That said, redness in a GP lens wearer is often a sign of a lens fitting problem or drying of the ocular surface related to the lens fit. Fitting issues can easily be identified by your contact lens specialist. Sometimes a minor change in fit, polishing the lens surface, a new material or a new lens care solution may solve the problem. Occasionally, eliminating redness can be challenging. Other issues should be explored for a persistent red eye in a lens wearer. These include underlying dry eye and allergy. All in all, it is best to discuss this with your contact lens fitter who can find the cause and help solve the problem.
I was supposed to have Lasik surgery, however, the doctor who was to perform the surgery said that because my mother had KC that there is a slight chance that laser surgery might cause keratoconus even though my eyes are healthy. Is that true?
Keratoconus has a genetic basis. Having a parent who has the disorder may increase your risk of developing keratoconus or of developing corneal thinning post-LASIK. You may also have subclinical evidence of keratoconus that has concerned your doctor. You should ask if his recommendation is based solely on your family history or if there are other factors like abnormal corneal topography. Ultimately, you have to decide if the risk is justified. Sometimes a second opinion is helpful. My advice is when it comes to your sight; it is better to err on the side of caution.
Does high pressure cause the thinning cornea to bulge?
A certain amount of internal pressure is normal. Normal pressure is a factor in maintaining the shape of your eye whether you have keratoconus or not. High pressure can be indicative of glaucoma but isn’t necessarily related to keratoconus.
Is Keratoconus always degenerative, or is it possible for it to stay at a mild level?
Keratoconus is a highly variable and unpredictable disease. Many patients have a mild form and do not progress significantly. However, there is no way to predict this for an individual.
Do most people have the condition in both eyes? If you do have it in one eye only, does that mean you might develop it in the other eye at some point? Is certain that you will? When will you know that you are in the clear?
I have noticed a daily aching pain in my right eye that also hurts when I blink or move my eye when my eye lid is closed. Is this normal for KC?
You are not alone. Many keratoconus patients complain of discomfort or outright pain. Since pain may also be a sign of other problems you should bring this to your doctor’s attention as soon as possible.
Is it common for people with keratoconus to feel more tired or require more sleep because their eyes are under more strain while they are awake?
Although this isn’t a common symptom, visual strain can be tiring and can lead to fatigue. Here too, I would discuss this with your doctor to insure that your correction is appropriate and that nothing else is amiss.